The Influence of Job Satisfaction and Burnout on Disability after Finger InjuriesArjan G.J. Bot, MD; John J. Kadzielski, MD; David Ring, MD, PhD;Massachusetts General Hospital

Introduction: Motivation, job satisfaction, burnout and secondary gain are factors which can influence return to work and disability after orthopaedic injuries. The current study evaluated the separate effects of job satisfaction, burnout, and secondary gain on arm-specific disability after a finger injury. Our null hypothesis was that job satisfaction and burnout are not associated with arm-specific or general disability as addressed with the DASH and SF-36 questionnaires respectively. In secondary analyses we address the null hypotheses that there is no influence of injury severity or worker’s compensation on disability.

Materials & Methods: Ninety-three employed patients with finger injuries were enrolled in this prospective IRB approved study. All patients were English speaking adults. Burnout (measured with Shirom-Melamed’s Burnout Measure, S-MBM), job satisfaction (measured with the Job Descriptive Index-questionnaire (JDI)) and demographics were assessed at initial visit. After six months, arm-specific disability was measured with the DASH (Disabilities of Arm Shoulder and Hand), pain was measured on an 11 point ordinal scale and general health status was measured with the SF-36 (Mental Component Scale: MCS; and Physical Component Scale: PCS). We tested the association of the SF-36, DASH and pain with the independent variables in a bivariate analysis (Spearman correlation for continuous, Mann-Whitney U for dichotomous and Kruskall-Wallis for categorical variables). Variables that had a p<0.10 in the bivariate analysis were inserted in a backwards stepwise linear regression analysis.

Results:There were 51 patients who completed follow-up; 45 were men and 6 women with an average age of 42 years (range, 18-68 years). The mean JDI score was 44, the mean S-MBM total score was 3.1, the mean DASH score was 12, the mean SF-36 PCS was 48, the mean SF-36 MCS was 49, and the mean pain score was 2.1. In multivariable analysis, pain and workers compensation status explained 52% of the variability in DASH (pain alone accounted for 49%); pain accounted for 14% of the variability in SF-36 PCS; and workers compensation accounted for 11% of the variation in the SF-36 MCS.

Conclusions: Worker’s compensation and pain are more important than job satisfaction and burnout in explaining variations in arm specific disability in patients with finger injury.